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Garcia v. Wexford Health Sources Inc.

United States District Court, S.D. Illinois

March 20, 2018

JUAN GARCIA, Plaintiff,



         I. Introduction

         Acting pro se, Plaintiff Juan Garcia brought the present lawsuit pursuant to 42 U.S.C. § 1983. An inmate at Menard Correctional Center (“Menard”), Plaintiff alleges Defendants violated his Eighth Amendment rights in regards to treatment of cysts on his testicles. Plaintiff alleges one count of deliberate indifference to serious medical needs against Defendants Trost and Lang, and a count alleging an unconstitutional policy or practice against Defendant Wexford. This matter is before the Court on two motions for summary judgment filed by Defendants. (Docs. 54, 59). For the reasons stated below, Defendant Lang's Motion is GRANTED and Defendants Trost's and Wexford's Motion is GRANTED in part and DENIED in part.

         II. Background

         Plaintiff Garcia has been an inmate with IDOC since 2007 and has been incarcerated at Menard since March of the same year. Defendant Wexford is a company contracted to provide certain medical services to inmates incarcerated by the Illinois Department of Corrections (“IDOC”). Defendant Trost, who is employed by Wexford, was the medical director at Menard from November 2013 to March 2017. Defendant Lang is a Correctional Medical Technician (“CMT”) at Menard.

         While incarcerated at Stateville Correctional Center in 2007, Plaintiff noticed cysts near his bilateral testicles. (Doc. 55-3, p. 4) He reported the cysts to medical staff and was referred for an ultrasound. (Id.). The ultrasound revealed epididymal cysts on Plaintiff's testicles-one on his right testicle measuring 1.4 cm and another on his left testicle measuring 1.6 cm. (Doc. 55-2, p. 2). Epidydymal cysts are fluid filled cysts in the tube or duct connecting the testicle to the vas deferens located above and behind the testicle. (Id.). While Defendant Trost contends that such cysts are typically painless, and do not require medical attention, Plaintiff disputes this contention, stating that his cysts are painful. Plaintiff, however, acknowledges that he did not experience any complaints associated with the cysts until 2009. (Doc. 55-3, p. 4). According to Dr. Trost, in rare cases, the cysts are removed when they rapidly increase in size or result in decreased blood flow. (Doc. 55-2, p. 2).

         In 2009, Plaintiff began to experience a burning feeling in his bilateral testicles, which he rated at a five out of ten. (Doc. 55-3, p. 4). He submitted a sick call request and was referred for another ultrasound. (Id.). The ultrasound was performed on August 17, 2009, and it revealed the small bilateral epididymal cysts consistent in size as previously documented. (Doc. 55-2, p. 2). Defendant Trost first evaluated Plaintiff on May 31, 2013 for complaints of right shoulder pain and prescribed Ibuprofen. (Id.). While Defendant maintains that Plaintiff did not complain of testicular pain during this visit, Plaintiff contends that he was not allowed to complain since his visit was for shoulder pain. (Doc. 55-2, p. 2; Doc. 62, p. 7). According to Plaintiff, inmates are not allowed to complain about issues other than the ones for which they are scheduled to visit the doctor. (Doc. 62, p. 7). He testified at his deposition that he had previously tried to bring up another medical issue during a visit, but “they wouldn't allow you to do that.” (Doc. 55-3, p. 10). Plaintiff did not provide any further specifics or detail other than to say that such prohibitions were given orally and applied to all healthcare visits. (Id.).

         Plaintiff indicates that he has been in constant pain from his testicles since August 2013. (Doc. 62, p. 11). Plaintiff presented to Defendant Lang, a Correctional Medical Technician, on September 29, 2013, complaining of testicular pain at a level of six or seven out of ten with swelling for the previous two and a half months. (Doc. 55-3, p. 10). According to Defendant Lang, she was not able to visualize any gross swelling or enlargement. (Doc. 60-3, p. 2). She referred Plaintiff to see a nurse practitioner or doctor, and Plaintiff was seen by a nurse practitioner a week later. (Id; Doc. 60-1, p. 15). Defendant Lang has no control over scheduling patients' visit, and is not responsible for doing so. (Doc. 60-3, p. 3). According to Plaintiff, he requested pain medication from Defendant Lang; she refused, and walked away from his cell. (Doc. 62, p. 7). Defendant Lang does not recall if Plaintiff requested ibuprofen or pain medication from her during this visit. (Doc. 60-3, p. 2). She is only able to prescribe medication listed on the IDOC protocol sheet. (Id.). Regardless, according to Defendant Lang, based on the protocol sheets and her medical training and judgment, Plaintiff's condition did not warrant pain medication at that time. (Id.). She instructed Plaintiff to inform the healthcare unit if the severity of his pain increased. (Id.).

         Plaintiff was evaluated by a non-party nurse practitioner at Menard on October 7, 2013. He reported complaints of testicular pain, and that twice in the past he had experienced pain with urination and penile discharge. (Doc. 62-, p. 7 - 8). The nurse practitioner noted cysts on Plaintiff's testicles that were consistent with the 2007 ultrasound. (Doc. 55-2, p. 3) The NP's assessment was that of testicular pain with a possible urinary tract infection, and the NP ordered a urinal analysis and culture and sensitivity for further diagnosis. (Id.). Plaintiff was also prescribed Bactrim, an antibiotic, and recommended Plaintiff increase his fluids and return for reevaluation in two weeks. (Id.).

         Plaintiff was seen by the non-party NP again on October 21, 2013. (Id.). He was diagnosed with testicular pain and was referred for an evaluation with a medical doctor. (Id.). Plaintiff was seen by a non-party doctor on October 31, who, upon finding Plaintiff's cysts to be consistent with the 2007 and 2009 ultrasounds, diagnosed Plaintiff with stable bilateral epididymal cysts. (Id. at 3 - 4). Plaintiff presented to nurse sick call on December 14, 2013 for complaints of testicular pain, but was not evaluated due to a dispute over a $5.00 copay. (Id. at 4; Doc. 62, p. 8).

         Plaintiff presented to nurse sick call on April 25, 2014, where he was evaluated by a non-party nurse for complaints of occasional testicular pain over the prior weeks, which he rated at a nine out of ten. (Doc. 55-2, p. 4). He was referred for an evaluation with a nurse practitioner or a doctor. (Id.). Plaintiff was seen by Dr. Trost on May 23, 2014 with complaints of bilateral testicular pain, and Plaintiff was again diagnosed with bilateral epididymal cysts. (Id.). While both Dr. Trost and the medical record indicate that Plaintiff was prescribed Ibuprofen, Plaintiff denies ever receiving Ibuprofen. (Id; Doc. 55-1, p. 11 - 12; Doc. 55-3, p. 17). According to Plaintiff, he requested pain medication during the May 23rd visit, and Dr. Trost stated that he would send Plaintiff some medication that would be delivered to Plaintiff's cell. (Doc. 62, p. 15). Plaintiff never received any medication, however. (Id.). He Indicates that nurses pass out the medication, and at that time, the inmates are required to sign a medication form to prove reception. (Id.). Plaintiff never signed such a form. (Id.).

         Plaintiff was next seen by a non-party NP on July 1, 2014 who identified bilateral epididymal cysts with complaints of tenderness upon palpation. (Doc. 55-2, p. 4). Dr. Trost indicates that the NP renewed the ibuprofen prescription, but this notion is disputed by Plaintiff. (Id; Doc. 62, p. 9).

         Plaintiff was seen again by Dr. Trost on July 18, 2014. During that visit, Plaintiff reported ongoing testicular pain without improvement, and he requested to have his cysts surgically removed and to see a urologist. (Doc. 55-2, p. 5). Dr. Trost submitted Plaintiff to collegial for consideration for a bilateral orchiectomy, which is the surgical removal of both testicles. (Id.). According to the referral record, this was done per Plaintiff's request. (Doc. 551, p. 17). According to Plaintiff, however, he did not request an orchiectomy; rather, he sought only the surgical removal of both cysts. (Doc. 62, p. 9). Regardless of whether Plaintiff requested an orchiectomy, Dr. Trost's referral was denied as it was determined that the cysts could be effectively managed on-site and that an orchiectomy was not medically necessary. (Doc. 55-2, p. 5).

         Dr. Trost saw Plaintiff on two occasions in August 2014 for unrelated issues. (Id.). Plaintiff presented to Dr. Trost again on October 7, 2014, again complaining of testicular pain. (Doc. 55-2, p. 5). Dr. Trost referred Plaintiff for an updated ultrasound. (Id.). The ultrasound revealed a 1.28 x 1.58 cm cyst on Plaintiff's right testicle and a 1.7 cm cyst on the left testicle, and otherwise normal testicles that were consistent with the prior studies. (Id.). Plaintiff does not ...

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